Rod or nail placement in the medullary cavity for securing bone fractures is a common practice in orthopedic surgery. Use of the rod is known to inherently produce better healing in more extreme fractures than other procedures in which the rod is omitted. Spanning the fracture zone, the rod imposes a rigidity to the fracture area that could otherwise be difficult to maintain during the prolonged period of mending. When left permanently in place, the rod reinforces the bone and reduces its susceptibility to refracture.
The interlocking intramedullary nail has been widely used in the treatment of long bone fractures in recent years. However, patients who suffered from infection after nailing are hard to deal with. The current management of this kind of infection consists of two main objectives, one of which is infection control, which usually is achieved by nail removal with debridement, lavage of the medullary canal and local delivery of antibiotics. Unfortunately, removal of the intramedullary nail causes a high risk of non-union or additional fractures, challenging surgeons to prevent such fractures with few guidelines for how this can be done. Generally, external fixation is substituted for the removed IM nail.
To fight the infection, antibiotic-impregnated beads have been used to fill the dead space and deliver high concentration of specific antibiotics to the infected sites simultaneously, but some defects limit the application of antibiotic beads. Specifically, filling dead space incompletely, being hard to take out, and a short period of implantation time. These beads have been replaced by antibiotic spacers, and antibiotic PMMA-coated guide rods. While these methods address the problem of infection, all of these methods are temporary and provide no significant stability to the fracture, except for the antibiotic PMMA-coated guide rods, which provide limited stability to axial and bending forces but no rotational stability. Essentially, none of these methods results in stability that is comparable to a locked intramedullary nail, and none is likely to consistently achieve bony union without a subsequent procedure. For this reason, surgeons have started using antibiotic impregnated PMMA bone cement (AIBC) coated IM nails to treat an infected long bone fractures.
Current methods for creating these coated nails are hap hazzard, involving make-shift molds or cumbersome and costly metal molds. The methods are slow and difficult and generally the coated IM nails require removal of excess bone cement such as cutting away the bone cement that oozes out between mold halves or drilling our the bone cement that fills the locking hardware holes. Thus, there is a need in the art for a simple, inexpensive kit for forming AIBC IM nails of any size, and a method for simply forming them.